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Equity and seeking treatment for young children with fever in Nigeria: a cross-sectional study in Cross River and Bauchi States

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Infectious Diseases of Poverty 2015年第1期4卷 1-8页

作者： Bikom Patrick Odu Steven Mitchell Hajara Isa Iyam Ugot Robbinson Yusuf Anne Cockcroft Neil Andersson CIET Trust 71 Oxford RoadSaxonwoldJohannesburg 2196South Africa CIET/PRAM Department of Family MedicineMcGill University5858 Côte-des-NeigesSuite 300MontrealQC H3Z 1Z1Canada Community Health Department and Roll Back Malaria Program CalabarCross River StateNigeria State Ministry of Health BauchiBauchi StateNigeria CIET Trust Botswana PO Box 1240GaboroneBotswana

Background:Poor children have a higher risk of contracting malaria and may be less likely to receive effective *** is an important cause of morbidity and mortality in Nigerian children and many cases of childhood fever are due to *** study examined socioeconomic factors related to taking children with fever for treatment in formal health ***:A household survey conducted in Bauchi and Cross River states of Nigeria asked parents where they sought treatment for their children aged 0–47 months with severe fever in the last month and collected information about household socio-economic *** also recorded whether there was a health facility in the *** used treatment of severe fever in a health facility to indicate likely effective treatment for *** analysis in each state examined associations with treatment of childhood fever in a health ***:43%weighted(%wt)of 10,862 children had severe fever in the last month in Cross River,and 45%wt of 11,053 children in *** these,less than half(31%wt Cross River,44%wt Bauchi)were taken to a formal health facility for *** were more likely to be taken to a health facility if there was one in the community(OR 2.31[95%CI 1.57–3.39]in Cross River,OR 1.33[95%CI 1.0–1.7]in Bauchi).Children with fever lasting less than five days were less likely to be taken for treatment than those with more prolonged fever,regardless of whether there was such a facility in their *** mothers were more likely to take children with fever to a formal health *** communities with a health facility in Cross River,children from less-poor households were more likely to go to the facility(OR 1.30;95%CI 1.07-1.58).Conclusion:There is inequity of access to effective malaria treatment for children with fever in the two states,even when there is a formal health facility in the *** the details of inequity of access in th

关键词： Severe fever Malaria Equity access to care Nigeria

Global health disparities in vulnerable populations of psychiatric patients during the COVID-19 pandemic

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World Journal of Psychiatry 2021年第4期11卷 94-108页

作者： Ailyn Diaz Ritika Baweja Jessica K Bonatakis Raman Baweja Department of Psychiatry and Behavioral Health Penn State University College of MedicineHersheyPA 17033United States

The coronavirus disease 2019 pandemic affects psychiatric patients disproportionately compared to the general *** this narrative review,we examine the impact of the pandemic on significant global health disparities affecting vulnerable populations of psychiatric patients:People of diverse ethnic background and color,children with disabilities,sexual and gender minorities,pregnant women,mature adults,and those patients living in urban and rural *** identified disparities cause worsened mental health outcomes placing psychiatric patients at higher risk for depression,anxiety and posttraumatic stress disorder *** psychiatric patients who are ethnic minorities display barriers to care,including collective trauma and structural *** and gender minorities with mental illness face discrimination and limited access to *** women with psychiatric diagnoses show higher exposure to domestic *** with disabilities face a higher risk of worsening *** adults with psychiatric problems show depression due to social *** patients who live in urban communities face pollutants and overcrowding compared to those living in rural communities,which face limited access to telehealth *** suggest that social programs that decrease discrimination,enhance communal resilience,and help overcome systemic barriers of care should be developed to decrease global health disparities in vulnerable population.

关键词： COVID-19 Pandemic Health disparities Global disparities Mental health disparities access to care

Effect of gynecologic oncologist availability on ovarian cancer mortality

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World Journal of Obstetrics and Gynecology 2014年第2期3卷 71-77页

作者： Sherri L Stewart Darryl Cooney Shawn Hirsch Lauren Westervelt Thomas B Richards Sun Hee Rim Cheryll C Thomas Division of Cancer Prevention and Control Centers for Disease Control and Prevention Atlanta GA 30341 United States Sci Metrika LLC Research Triangle Park North Carolina NC 27703 United States

AIM: To determine the association between the distribution of gynecologic oncologist(GO) and populationbased ovarian cancer death rates. METHODS: Data on ovarian cancer incidence and mortality in the United States was supplemented with United States census data, and analyzed in relation to practicing GOs. GO locations were geocoded to link association between county variables and GO availability. Logistic regression was used to measure areas of high and low ovarian cancer mortality, adjusting for contextual variables. RESULTS: Practicing GOs were unevenly distributed in the United States, with the greatest numbers in metropolitan areas. Ovarian cancer incidence and death rates increased as distance to a practicing GO increased. A relatively small number(153) of counties within 24 miles of a GO had high ovarian cancer death rates compared to 577 counties located 50 or more miles away with high ovarian cancer death rates. Counties located 50 or more miles away from a GO practice had an almost 60% greater odds of high ovarian cancer mortality compared to those with closer practicing GOs(OR = 1.59, 95%CI: 1.18-2.15). CONCLUSION: The distribution of GOs across the United States appears to be significantly associated with ovarian cancer mortality. Efforts that facilitate outreach of GOs to certain populations may increase geographic access.

关键词： Ovarian cancer Gynecologic oncologists Mortality access to care

Evaluating the implementation of rapid diagnostic tests in a malaria elimination setting

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Infectious Diseases of Poverty 2020年第4期9卷 148-148页

作者： Di Liang Jia-Jie Jin Wei-Ming Wang Yuan-Yuan Cao Guo-Ding Zhu Hua-Yun Zhou Jun Cao Jia-Yan Huang Key Lab of Health Technology Assessment National Health CommitteeShanghaiChina School of Public Health Fudan UniversityShanghaiChina Key Laboratory of National Health Commission on Parasitic Disease Control and Prevention Key Laboratory of Jiangsu Province on Parasite and Vector Control TechnologyJiangsu Institute of Parasitic DiseasesWuxiChina Center for Global Health School of Public HealthNanjing Medical UniversityNanjingChina Public Health Research Center Jiangnan UniversityWuxiChina

Background It was recommended that malaria rapid diagnostic tests(RDTs)should be available in all epidemiological *** evidence was limited on the implementation of RDTs and its effectiveness in malaria elimination *** study examined the implementation of RDTs and how it affected the diagnosis of imported malaria patients in Jiangsu Province,*** To scale up RDTs,this study developed an intervention package with four major elements covering the supply of RDT test,the training on RDTs,the monitoring and management of RDT use,and the advocacy of *** using a pretest-posttest control group design,we implemented the interventions in 4 cities in Jiangsu Province with the rest nine cities as controlled areas,from January 2017 to January ***-in-Difference approach was used to evaluate the impact of the scale-up of RDTs on the identification of malaria *** binary outcome measures were included to indicate delayed malaria diagnosis,malaria cases with confirmed malaria diagnosis at township-level institutions,and severe malaria cases,*** probability regression was performed with time and group fixed effects and the interaction term between time and *** Intervention areas received sufficient RDT test supply,regular professional training programs,monthly tracking and management of RDT supply and use,and health education to targeted *** implementation of interventions was associated with 10.8%(P=0.021)fewer patients with delayed *** intervention areas did not see a higher likelihood of having confirmed diagnosis from township-level institutions(coefficient=-0.038,P=0.185)or reduced severe malaria cases(coef.=0.040,P=0.592).Conclusions The comprehensive package of RDT implementation in this study is promising in scaling up RDT use and improving access to care among malaria patients,especially in malaria elimination settings.

关键词： Malaria Rapid diagnostic tests access to care Pretest-posttest control group design